Personal Blog of Alex Mohseni, focusing on Innovation and Technology in Health and Medicine

Wednesday, December 10, 2014

Nursing home comparison using quality and safety data from actual inspections

I put together an interactive map with data tables showing nursing home quality data from Nursing Home Compare. The table is specifically the Nursing Home Deficiencies table, which tabulates deficiencies in safety, fire safety, and health.

In the above interactive map, you can search for nursing homes by adjusting the filters on the right side. The filters include state, number of deficiencies, general type of deficiencies (they are generally categorized into fire safety and health), and "scope severity code", which is well defined on the following website: http://www.in.gov/isdh/reports/QAMIS/ltccr/matrlink.htm. There is a good report on the completeness and accuracy of Nursing Home Compare data from the OIG on this site: http://oig.hhs.gov/oei/reports/oei-01-03-00130.pdf. Here are the typical types of nursing home deficiencies cited:

Allow residents to easily view the results of the nursing home's most recent inspection.

Reasonably accommodate the needs and preferences of each resident.

Keep all essential equipment working safely.

Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.

Upon the death of a resident, convey the resident's personal funds and an accounting of those funds to the appropriate party.

Provide at least one room set aside to use as a resident dining room and for activities, that is a good size, with good lighting, air flow and furniture.

Let residents refuse treatment, refuse to take part in an experiment, or formulate advance directives.

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing.

Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse.

Provide or obtain laboratory services only when ordered by the attending physician.

Keep accurate, complete and organized clinical records on each resident that meet professional standards.

Provide housekeeping and maintenance services.

Conduct initial and periodic assessments of each resident's functional capacity.

Ensure each resident receives an accurate assessment by a qualified health professional.

Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Allow residents the right to participate in the planning or revision of care and treatment.

Ensure services provided by the nursing facility meet professional standards of quality.

Provide necessary care and services to maintain or improve the highest well being of each resident .

Ensure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions.

Ensure residents maintain acceptable nutritional status.

Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being.

At least once a month, have a licensed pharmacist review each resident's medication(s) and report any irregularities to the attending doctor.

Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards.

Corridor and hallway doors that block smoke.

Automatic sprinkler systems that have been maintained in working order.

Exits that are free from obstructions and can be used at all times.

Proper medical gas storage and administration areas.

Properly installed electrical wiring and equipment.

Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system.

Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.

Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents.